[Current trends and problems in chemotherapy for elderly patients with advanced gastric cancer]

To assess current trends and problems in chemotherapy for elderly patients with unresectable gastric cancer.

Patients with unresectable gastric cancer were divided into two groups: an elderly group aged 70 years or older (n=28), and a control group aged younger than 70 years (n=46). The feasibility, safety, and efficacy of chemotherapy were compared between the two groups. The induction rate for a first-line treatment did not differ between the groups (89% for the elderly group versus 93% for the control group). A regimen comprising S-1 and cisplatinum (CDDP) was selected most frequently as the first-line treatment in both groups. When an analysis was restricted to patients given S-1 and CDDP, the elderly group showed fewer cycles of CDDP administration, a higher rate of grade 3 or worse adverse events, a lower rate of switching to a second-line treatment, and a shorter overall survival than the control group, although the p values did not reach a significant level. Among patients aged 70 years or more, those given S-1 alone showed an overall survival equivalent to that for patients given S-1 and CDDP. In conclusion, in clinical practice, it seems appropriate to consider whether the S-1+CDDP regimen is the most optimal first-line treatment for elderly patients with gastric cancer.